Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

scholarly journals Unusual coexistence of first and second branchial fistulas: clinical case and review of the literature

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094430
Author(s):  
Danqing Liu ◽  
Guangqi Li ◽  
Jun Qiu ◽  
Jianyan Wang ◽  
Genwang Pei
Keyword(s):  
Clinical Signs ◽  
Preoperative Imaging ◽  
Review Of The Literature ◽  
False Positive Diagnosis ◽  
Fistula Recurrence ◽  
History Of ◽  
Physical Examinations ◽  
Missed Diagnosis ◽  
The Right

Branchial fistulas are uncommon in the clinical setting. The coexistence of first and second branchial fistulas has not been previously reported. We herein describe a 12-year-old girl who presented with a 2-year history of repeated swelling and purulence behind the right earlobe and neck. According to the patient’s physical and auxiliary examination findings, she was diagnosed with coexisting first and second branchial fistulas, both of which were completely removed by surgery. No clinical signs of fistula recurrence were present at the patient’s 20-month postoperative follow-up. Ipsilateral coexisting first and second branchial fistulas are very rare; thus, a false-positive diagnosis can easily occur if the doctor does not carefully perform specialized physical examinations. Surgery is an effective method for treating this condition. Adequate preoperative imaging preparation is imperative to ensure the most effective course of treatment. The purpose of this article is to improve clinicians’ awareness of this disease, thereby effectively reducing the rates of missed diagnosis and recurrence.

scholarly journals A case report: delayed right ventricular pericardial fistula and aneurysm following penetrating traumatic injury—a controversial aetiology

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Martina Steinmaurer ◽  
Blanche Cupido ◽  
Matthew Hannington ◽  
Rodgers Manganyi
Keyword(s):  
Pericardial Effusion ◽  
Right Ventricular ◽  
Cardiac Tamponade ◽  
Traumatic Injury ◽  
Clinical Signs ◽  
The Body ◽  
Delayed Presentation ◽  
True Aneurysm ◽  
History Of

Abstract Background Right ventricular aneurysms (RVAs) are rare. We present a case with a combined RVA and right ventricular pericardial fistula resulting in a pericardial effusion and cardiac tamponade. The RVA was detected 47 days after the patient suffered a gunshot wound. This report adds to the body of scarce literature on RVA aetiology, diagnoses, and treatment. Case summary A 30-year-old male patient presented with worsening respiratory distress over a 7-day period with clinical signs of cardiac tamponade following a history of a gunshot (with associated liver laceration, pulmonary embolism, right nephrectomy, and sepsis) 47 days prior. Transthoracic echocardiography showed a large circumferential pericardial effusion and an RVA. The patient was emergently taken for surgical repair of the RVA. Discussion Our case presents a delayed presentation of a gunshot heart and an aetiology with indications of and against a true aneurysm. It brings attention to possible complications of penetrating precordial injuries, with the need for consideration and possible evaluation at follow-up. The literature on the operative excision of RVA is reviewed and various aetiological factors and consequences are discussed.

scholarly journals Efficacy and Safety of Bevacizumab-Containing Therapy in Newly Diagnosed Ovarian Cancer: ROSiA Single-Arm Phase 3B Study

2016 ◽  
Vol 27 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Amit M. Oza ◽  
Frédéric Selle ◽  
Irina Davidenko ◽  
Jacob Korach ◽  
Cesar Mendiola ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Adverse Events ◽  
Single Agent ◽  
Clinical Signs ◽  
Progression Free Survival ◽  
Gynecology And Obstetrics ◽  
Common Grade ◽  
History Of ◽  
Grade 3

ObjectiveThe aim of this study was to assess the safety and efficacy of extending bevacizumab therapy beyond 15 months in nonprogressive ovarian cancer.Patients and MethodsIn this multinational prospective single-arm study (ClinicalTrials.gov NCT01239732), eligible patients had International Federation of Gynecology and Obstetrics stage IIB to IV or grade 3 stage I to IIA ovarian cancer without clinical signs or symptoms of gastrointestinal obstruction or history of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within the preceding 6 months. Prior neoadjuvant chemotherapy was permitted. After debulking surgery, patients received bevacizumab 15 (or 7.5) mg/kg every 3 weeks (q3w) with 4 to 8 cycles of paclitaxel (investigator’s choice of 175 mg/m2 q3w or 80 mg/m2 weekly) plus carboplatin AUC 5 to 6 q3w. Single-agent bevacizumab was continued until progression or for up to 24 months. The primary end point was safety.ResultsBetween December 2010 and May 2012, 1021 patients from 35 countries began study treatment. Bevacizumab was administered at 15 mg/kg in 89% of patients and for more than 15 months in 53%. Median follow-up duration was 32 months (range, 1–50 months). The most common all-grade adverse events were hypertension (55% of patients), neutropenia (49%), and alopecia (43%). The most common grade 3 or higher-grade adverse events were neutropenia (27%) and hypertension (25%). Bevacizumab was discontinued because of proteinuria in 5% of patients and hypertension in 3%. Median progression-free survival (PFS) was 25.5 months (95% confidence interval, 23.7–27.6 months).ConclusionExtended bevacizumab demonstrated increased incidences of proteinuria and hypertension compared with 12 or 15 months of bevacizumab in previous trials, but these rarely led to bevacizumab discontinuation. Median PFS is the longest reported for frontline bevacizumab-containing therapy. The longer bevacizumab duration beyond 15 months in this study may improve PFS without substantially compromising safety.

scholarly journals Diagnostic Workup and Treatment of a Rare Apocrine Hidrocystoma Affecting the Oral Mucosa: A Clinical and Histological Case Report

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Pier Paolo Poli ◽  
Luca Creminelli ◽  
Valeria Moramarco ◽  
Alessandro Del Gobbo ◽  
Franco Ferrante ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Mucosa ◽  
Clinical Signs ◽  
Sweat Glands ◽  
Histopathological Analysis ◽  
Cystic Tumors ◽  
Left Posterior ◽  
History Of ◽  
Submucosal Mass

Apocrine hidrocystomas are rare benign cystic tumors originating from the secretory portion of apocrine sweat glands. To the best of our knowledge, there is no evidence currently available reporting the presence of apocrine hidrocystomas in the oral cavity. Therefore, this case report aims to describe the clinical and histological features of an apocrine hidrocystoma affecting the oral mucosa. A 69-year-old male patient presented with a 1-year history of a solitary, well-circumscribed, submucosal mass in the left posterior buccal mucosa. The clinical examination revealed a yellowish soft, fluctuant, and painless lesion with no clinical signs of erythema or ulcerations of the overlying epithelium. The entire lesion was excised and histopathological analysis confirmed the diagnosis of apocrine hidrocystoma. No recurrence was observed after a 1-year follow-up.

scholarly journals Hypertrophic osteopathy associated with a bronchial foreign body (grass awn) in a dog: a case report

2012 ◽  
Vol 57 (No. 11) ◽  
pp. 618-621 ◽  
Author(s):  
A. Palumbo Piccionello ◽  
F. Dini ◽  
AM Tambella ◽  
M. Cerquetella ◽  
C. Vullo
Keyword(s):  
Foreign Body ◽  
Bone Lesion ◽  
Clinical Signs ◽  
Bone Apposition ◽  
Foreign Body Removal ◽  
Clinically Normal ◽  
History Of ◽  
The Right ◽  
Grass Awn

A five-year-old dog was referred with a five-month history of lethargy, decreased appetite, cough and intermittent forelimb lameness. Radiographs revealed an intra-thoracic lesion and a marked periosteal bone apposition of the second digit on the left forelimb. As it was palisading and circumferential, the latter appeared typical of hypertrophic osteopathy (HO). A grass awn in a sub-lobar ramification of the right caudal bronchus was identified and removed by bronchoscopy. At three months follow-up, the digit appeared clinically normal. On radiographs the periosteal bone reaction had decreased, indicative of resolving hypertrophic osteopathy. Thoracic radiographs showed no abnormalities five months after foreign body removal and the bone lesion on the digit had disappeared. Successful treatment of the pulmonary foreign body abscess led to spontaneous regression of HO and eventually to complete resolution of clinical signs. To the authors’ knowledge, this is the first reported case of HO secondary to a bronchial-pulmonary grass an abscess.

scholarly journals Effect of doxycycline on stifle lameness: a preliminary clinical observation in twelve dogs

2011 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Kei Hayashi ◽  
Joseph D. Frank ◽  
Paul A. Manley ◽  
Peter Muir
Keyword(s):  
Clinical Signs ◽  
Poor Response ◽  
Positive Outcome ◽  
Presumptive Diagnosis ◽  
Once Daily ◽  
Doxycycline Treatment ◽  
History Of ◽  
Group A ◽  
Group B

The clinical efficacy of oral doxycycline was evaluated in twelve dogs with stifle arthritis and a presumptive diagnosis of early cruciate disease. Doxycycline (2.5-4.5 mg/kg once daily) was administered orally for 3 to 8 weeks. Eight dogs, who presented prior to the treatment with clinical signs of 4 weeks or fewer duration (group B), had a good response to doxycycline, whereas four dogs with a longer history of lameness (group A) had a poor response. The follow-up periods ranged from 2 to 12 months after discontinuation of the doxycycline treatment (median=6.5 months, 3 months in group A, and 9.5 months in group B). There was a significant correlation between the duration of lameness and the subjective grading of clinical improvement. In 68% of these cases of dogs with stifle arthritis (8/12), the oral administration of doxycycline resulted in the improvement of lameness, even after discontinuation of doxycycline. Careful selection of patients based on the duration of their lameness appears to be crucial in order to achieve a positive outcome.

Rectal ganglioneuroma in a dog

1999 ◽  
Vol 35 (2) ◽  
pp. 107-110 ◽  
Author(s):  
ME Reimer ◽  
MS Leib ◽  
MS Reimer ◽  
GK Saunders ◽  
SA Johnston
Keyword(s):  
Gastrointestinal Tract ◽  
Surgical Resection ◽  
Large Bowel ◽  
Clinical Signs ◽  
Successful Outcome ◽  
First Report ◽  
History Of ◽  
The Masses

An 18-month-old, spayed female Australian terrier cross was presented with a 10-month history of chronic large bowel diarrhea. Ulceration and two proliferative masses in the rectum were seen on colonoscopy. Surgical resection was performed to remove the masses, and the dog recovered without complications related to surgery. Histopathology was consistent with the diagnosis of ganglioneuroma. The dog had no clinical signs of disease within three months of surgery and was completely normal 2.5 years after diagnosis. This is the first report providing follow-up and successful outcome of a ganglioneuroma in the gastrointestinal tract of a dog.

Left Ventricular Inflow Tract Obstruction Secondary to a Myxoma in a Dog

2011 ◽  
Vol 47 (3) ◽  
pp. 217-223 ◽  
Author(s):  
M. Josefa Fernandez-del Palacio ◽  
Joaquin Sanchez ◽  
Jesus Talavera ◽  
Carlos Martínez
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Clinical Signs ◽  
Left Ventricular ◽  
Exercise Intolerance ◽  
Cardiac Murmur ◽  
Cardiac Apex ◽  
Spectral Doppler ◽  
History Of

This is the first description of a left ventricular inflow tract obstruction secondary to a myxoma in a dog. A 4 yr old, male fox terrier presented with a 1 mo history of cough and exercise intolerance. Expiratory dyspnea, pulmonary crackles, irregular cardiac rhythm, and a grade 4/6 pansystolic cardiac murmur over the left cardiac apex were the most important features on physical examination. The electrocardiogram revealed atrial fibrillation. Thoracic radiographs showed left-sided cardiac enlargement and mild pulmonary edema, especially in the hilar area. Two-dimensional transthoracic echocardiography showed severe left atrial dilation and a homogenous, echodense mass involving both leaflets of the mitral valve and the posteromedial papillary muscle, inducing mitral stenosis. Spectral Doppler echocardiography was consistent with severe left ventricular inflow tract obstruction secondary to a mass. Therapy for congestive heart failure was prescribed. Follow-up examinations of the dog 1 mo, 2 mo, and 6 mo after diagnosis showed an improvement in clinical signs, but similar echocardiographic features. Eleven months after diagnosis, the dog was euthanized at the owner's request because of recurrent congestive heart failure. The postmortem examination showed the cardiac tumor was consistent with a myxoma.

scholarly journals Posaconazole in the treatment of refractory Purpureocillium lilacinum (former Paecilomyces lilacinus) keratitis: the salvation when nothing works

2019 ◽  
Vol 12 (4) ◽  
pp. e228645 ◽  
Author(s):  
Mariana Almeida Oliveira ◽  
Analia Carmo ◽  
Andreia Rosa ◽  
Joaquim Murta
Keyword(s):  
Case Report ◽  
Clinical Condition ◽  
Penetrating Keratoplasty ◽  
Contact Lenses ◽  
Clinical Signs ◽  
Paecilomyces Lilacinus ◽  
Purpureocillium Lilacinum ◽  
History Of ◽  
History Of Pain

We report a case of a 41-year-old woman, wearer of contact lenses who was presented to the emergency room with a 2-month history of pain and red eye. She presented with a severe keratitis refractory to quinolones, fortified antibiotics and clotrimazole. Due to the risk of perforation, a tectonic penetrating keratoplasty (PK) was performed. Clinical signs of keratitis recurrence were observed and cultures were positive for Purpureocillium lilacinum (former Paecilomyces lilacinus). The patient did not improve on topical amphotericin B and intracameral voriconazole. Worsening of clinical condition required a new PK. Oral posaconazole was initiated postoperatively and suspended at the fourth postoperative month. The cornea remains clear until the last follow-up visit, 12 months after the second graft. To our knowledge, this is the second case report that documents the effectiveness of oral posaconazole in a refractory P. lilacinus keratitis, resistant to other second-generation triazoles and conventional antifungals.

scholarly journals Brachial plexus neuropathy or neuritis in the dog and cat: A report of 4 spontaneous cases

2018 ◽  
Vol 51 (1) ◽  
pp. 57 ◽  
Author(s):  
A. F. KOUTINAS (Α.Φ. ΚΟΥΤΙΝΑΣ) ◽  
Z. S. POLIZOPOULOU (Ζ.Σ. .ΠΟΛΥΖΟΠΟΥΛΟΥ) ◽  
G. GEORGIADIS (Γ. ΓΕΩΡΓΙΑΔΗΣ) ◽  
M. N. SARIDOMICHELAKIS (Μ.Ν. ΣΑΡΙΔΟΜΙΧΕΛΑΚΗΣ) ◽  
M. PATSIKAS (Μ.Ν. ΠΑΤΣΙΚΑΣ)
Keyword(s):  
Brachial Plexus ◽  
Muscular Atrophy ◽  
Clinical Signs ◽  
Neurogenic Muscular Atrophy ◽  
Neuromuscular Abnormalities ◽  
History Of ◽  
Tentative Diagnosis ◽  
Cessation Of Treatment ◽  
Made In

One kitten and three adult dogs were admitted with a history of an acute or progressive lower motor neuron disease involving asymmetrically the thoracic limbs. Neurogenic muscular atrophy was also present affecting the relevant muscles in all the animals. As no other neuromuscular abnormalities could be detected on physical, radiological and clinicopathologic examination, a tentative diagnosis of brachial plexus neuropathy or neuritis was made. In the cat diagnosis was confirmed by electrophysiological testing demonstrating decreased sensory conduction velocity of the ulnar nerve and denervation potentials. The administration of prednisolone at antiinflammatory dosage for 3 weeks abolished or decreased the severity of the clinical signs in all the cases. Recurrence of the disease, one to 6 months after the cessation of treatment, was detected or reported for the 3 dogs where a follow-up was possible.

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